When President Obama earlier this year announced the National Cancer Moonshot initiative, Christiana Care’s Helen F. Graham Cancer Center & Research Institute was already positioned to play a key role in the nation’s quest to eliminate cancer.
The Graham Cancer Center, an NCI Community Oncology Research Program, had already established a special partnership with The Wistar Institute, an NCI- designated research institute in Philadelphia. The unique relationship between these leaders in cancer care and research represents a new cancer center model that offers patients access to more innovative research, earlier-phase clinical trials and better care.
“The whole idea of the ‘moonshot’ is to move research along rapidly so that we can move forward in cancer care,” said Nicholas J. Petrelli, M.D., FACS, Bank of America Endowed medical director of the Graham Cancer Center.
“When we established this historic partnership, we envisioned our physicians joining with Wistar scientists to move translational research quickly into the community — and that is exactly what we are doing,” Dr. Petrelli said.
The Graham Cancer Center excels at applying the benefits of research to patient care. The national accrual rate for NCI clinical trials — the percentage of patients receiving the most advanced care through enrollment in cancer clinical trials — is approximately 3 percent.
“Our accrual rate is anywhere from 18 to 22 percent — that’s six to seven times the national average,” Dr. Petrelli said. “Translational research means bringing bench research to patient care, and we are able to do that at a high rate and in a short period of time.”
Bringing unique strengths to a vital partnership
The Graham Cancer Center is a national leader in advancing the leading edge of cancer research, eliminating cancer disparities in community care and providing the benefits of advanced clinical trials to patients. Eighty-five percent of all cancer care in the United States is provided through community-based hospitals, and the Graham Cancer Center cares for some 3,200 new cancer patients each year.
The Wistar Institute, the nation’s first independent institution devoted to medical research, is an international leader in basic biomedical cancer research. Together, Wistar scientists and the Graham Cancer Center physicians are collaborating on translational research projects targeting lung cancer, melanoma, ovarian cancer, breast cancer and more.
“This partnership enables a whole spectrum of collaborative bench-to-bedside cancer research,” Dr. Petrelli said.
The relationship spans a wide variety of research areas.
“Programs like the Moonshot, which are truly meant to transform how we care for cancer patients in the 21st century, can only be successful through collaboration,” said Dario C. Altieri, M.D., president and CEO of The Wistar Institute. “By bringing together scientists and clinicians in this unique model of collaboration with the Graham Cancer Center, we have created the conditions to make available the most significant advances in cancer research to our communities and neighborhoods.”
For example, Christiana Care offers a lung-screening program using low-dose CT scans, which has helped to lower the mortality rate for lung cancer by 20 percent. Recently, after a Wistar research scientist discovered a biomarker for detecting early lung cancer via a blood sample, Christiana Care began applying that biomarker to its screening program.
“We already have a cohort of 178 patients statewide,” Dr. Petrelli said. “Because of our relationship with Wistar, this has gone from bench to bedside very rapidly.”
In another trial, the Graham Cancer Center and Wistar are collaborating on investigating a targeted therapy for advanced metastatic melanoma. That research is looking at myeloid derived suppressor cells, a group of immune cells that expand in pathological situations such as chronic infection and cancer.
One of the Graham Cancer Center’s important research resources is the Tissue Procurement Center. As part of one of the nation’s largest community-based health systems at Christiana Care, the Graham Cancer Center has been able to preserve, clinically annotate and make available for research a large tissue bank of widely diverse patient specimens through the Tissue Procurement Center. The Tissue Procurement Center contains more than 5,000 high-quality tissue and blood samples from patients with lung, breast, colorectal, head and neck, ovary, brain and other cancers. The Graham Cancer Center has been a biospecimen collection center for the National Institutes of Health Cancer Genome Atlas project.
The Tissue Procurement Center is a resource that has proved highly valuable to Wistar researchers. “We’ve already been able to provide some 600 blood and tissue specimens to our scientists at The Wistar Institute,” Dr. Petrelli said.
Some of those tissues landed in the lab of a Wistar scientist and helped identify a panel of biomarkers circulating in the blood that could detect lung cancer in high-risk patients. The research is so promising that OncoCyte, a developer of new, non-invasive products for cancer detection, announced a global licensing agreement to acquire commercial rights to what is a revolutionary non-invasive blood test to detect early-stage lung cancer.
“The hope is that this test can confirm a patient’s diagnosis and address the high false-positive rate obtained via low-dose computed tomography, currently the gold standard for early lung cancer diagnosis,” Dr. Petrelli said. If successful scientific results are achieved, OncoCyte will work with Wistar to fully validate the test in 2016 and set up its commercial launch.
The need for an effective early diagnostic tool is especially dire in lung cancer, where patients have an 80 percent chance of five-year survival after diagnosis in the earliest stages, but only a 1 percent chance if found in stage IV when it is commonly diagnosed and difficult to treat.
The Graham Cancer Center also brings to the Wistar partnership the resources of its statewide High-Risk Familial Cancer Registry, one of only three such state registries in the U.S. The registry houses data from more than 6,600 families representing more than 260,000 individuals whose genetic makeup puts them at high risk for cancer. The registry program, which also offers education, screening, and genetic counseling and gene testing for the families, provides a core resource for future genetic, environmental and epidemiological research.
Advancing the frontiers of cancer research
Through its Gene Editing Institute, the Graham Cancer Center is also distinguished as a leader in personalized genetic medicine. Led by world-renowned molecular biologist and gene-editing pioneer Eric Kmiec, Ph.D., the Gene Editing Institute is unlocking the genetic mechanisms that drive cancer and that can lead to revolutionary new therapies and treatments.
These efforts include developing the next generation of precise genetic tools, such as CRISPR (clustered regularly interspaced short palindromic repeats) and TALENs (transcription-activator-like effector nucleases), which can manipulate and control genetic material to help develop revolutionary new cancer therapies and pharmaceuticals. By using these methods of cutting DNA, researchers can remove a mutated gene and insert a normal gene into the DNA.
In a breakthrough discovery, researchers at the Gene Editing Institute found that combining CRISPRs and single-stranded DNA oligodeoxynucleotides — short strands of synthetic DNA — greatly enhances the precision and reliability in editing the human genome. With this combination, researchers are better able to identify and develop innovative therapies and pharmaceuticals to revolutionize cancer treatment.
“You can also recreate a genetic mutation in cell lines then test those cell lines with new drugs as a rapid way to drug discovery,” Dr. Petrelli explained. “Wistar is into the research of new drug discovery, so this is another good way of partnering with them.”
Programs like these are just a sample of what can be accomplished with a partnership like the one between the Graham Cancer Center and The Wistar Institute.
“Both institutions are committed to a unique model of innovation in merging the strengths of an NCI basic-science center and a large hybrid academic community cancer center,” Dr. Petrelli said. “That’s why, in a very short period of time, the partnership has been so successful. This is the first collaboration of its kind in the U.S. It is the sort of partnership that is needed to make substantial contributions to the Cancer Moonshot, and it’s happening first here in Delaware, the First State.”